Pharmacology

Question 1

Bethanechol

Answer 1

Direct cholinergic agonist
activates bowel and bladder
resistant to AChE
Bethany, call me to activate your bowel and bladder!

Question 2

Carbachol

Answer 2

Constricts pupil and relieves intraocular pressure in glaucoma
“Carbon copy of ACh”

Question 3

Methacholine

Answer 3

Challenge test for diagnosis of asthma

Question 4

Pilocarpine

Answer 4

Potent stimulator of sweat, tears, and saliva
Open-angle and closed-angle glaucoma

“You cry, drool, and sweat on your pillow”

Question 5

3 drugs for Alzheimers

Answer 5

Donepezil
Galantamine
Rivastigmine

Question 6

Used for diagnosis of Myasthenia gravis

AChE inhibitor

Answer 6

Edrophonium

Question 7

What is neostigmine? What is it used for?

Answer 7

AChE
myasthenia gravis
reversal of neuromuscular blockade (post-op)
post op & neurogenic ileus and urinary retention

Question 8

Does neostigmine cross the BBB?

Answer 8

no - neo CNS = no CNS penetration

Question 9

Another drug used for myasthenia gravis

Answer 9

Pyridostigmine

Question 10

This AChE crosses the BBB and is used for anticholinergic toxicity

Answer 10

Physostigmine

Question 11

What is the anecdote to organophosphate poisoning?

Answer 11

atropine (competitive inhibitor) + pralidozime (regenerates AChE if given early)

Question 12

What are these used for?

Oxybutynin
Solifenacin
Tolterodine

Answer 12

muscarinic antagonist for GU

reduce bladder spasms and urge urinary incontinence

Question 13

What is scopolamine used for?

Answer 13

muscarinic antagonist for motion sickness

Question 14

What are ipratropium and tiotropium used for?

Answer 14

anti-muscarinic

COPD, asthma

Question 15

What is Benztropine used for?

Answer 15

anti-muscarinic for Parkinsons

“Park the Benz”

Question 16

What are hyoscyamine and dicyclomine used for?

Answer 16

anti-muscarinic for GI

IBS

Question 17

What is glycopyrrolate used for?

Answer 17

GI, respiratory

reduces drooling, peptic ulcers
prop to reduce airway secretions

Question 18

Symptoms of atropine toxicity?

Answer 18

hot as a hare
dry as a bone
red as a beet
blind as a bat
mad as a hatter
tachycardia

Question 19

What GPCR does albuterol, salmeterol bind? What are they used for?

Answer 19

B2 > B1

acute asthma or COPD

Question 20

What GPCR does dobutamine bind?

Answer 20

B1 > B2

heart failure, cardiac stress testing

Question 21

What GPCR does dopamine bind?

Answer 21

low dose: D1, D2
medium dose: B1, B2
high dose: alpha1, alpha2

Question 22

What GPCR does NE bind to?

Answer 22

alpha1 > alpha2 > beta1

Question 23

What GPCR does epi bind to?

Answer 23

Beta > alpha

Question 24

What GPCR does phenylephrine bind? What is it used for?

Answer 24

alpha1 > alpha2

hypotension, ocular procedures, rhinitis

Question 25

What is the MOA of amphetamine? | What is it used for?

Answer 25

indirect sympathetic agonist reuptake inhibitor released stored catecholamines; narcolepsy, obesity, ADHD

Question 26

What is the MOA of cocaine? | What is it used for?

Answer 26

indirect general agonist NE reuptake inhibitor; vasoconstriction & local anesthesia some ENT procedures

Question 27

What is the MOA of ephedrine? | What is it used for?

Answer 27

indirect general agonist releases stored catecholamines; nasal decongestion, urinary incontinence, hypotension

Question 28

What receptors act on Gq?

Answer 28

Cutesies HAV 1 M&M ``` H1 alpha1 V1 M1 M3 ```

Question 29

What receptors act on Gi?

Answer 29

Mad2s M2 alpha2 D2

Question 30

What receptors act on Gs?

Answer 30

``` V2 D1 H2 B1 B2 ```

Question 31

What drug blocks choline transfer into presynaptic neuron?

Answer 31

hemicholinium

Question 32

What drug blocks ACh packaging into vesicles?

Answer 32

vesamicol

Question 33

What drug blocks ACh vesicle release?

Answer 33

Botulinum toxin

Question 34

What drug blocks Tyrosine to DOPA?

Answer 34

metyrosine

Question 35

What drug blocks NE packaging into vesicles?

Answer 35

reserpine

Question 36

What drugs block reuptake of NE?

Answer 36

cocaine TCAs amphetamines

Question 37

What drugs cause NE release?

Answer 37

amphetamine | ephedrine

Question 38

What drugs bock NE release from presynaptic terminal?

Answer 38

bretylium | guanethidine

Question 39

Which drugs act on microtubules?

Answer 39

``` vinblastine, vincristine Taxels - paclitaxel, docataxel mebendazole, albendazole griseofulvin colchicine (blocks phagocyte movement) ```

Question 40

How to treat malignant hyperthermia or neuroleptic malignant syndrome?

Answer 40

dantrolene --> blocks Ca++ release for SR to prevent skeletal muscle contraction

Question 41

This is the most common benzo used for endoscopy

Answer 41

Midazolam

Question 42

This barbiturate has a high potency, high lipid solubility, and rapid entry into the brain. Used for induction of anesthesia and short surgical procedures

Answer 42

thiopental

Question 43

PCP analog that acts as a dissociative anesthetic - blocks NMDA receptors - can cause hallucinations and bad dreams Increases cerebral blood flow

Answer 43

ketamine

Question 44

Used for sedation in the ICU, rapid anesthesia induction, short procedures

Answer 44

propofol

Question 45

What are the local anesthetics? How do they work?

Answer 45

block Na+ channels **preferentially bind to activated Na+ channels (rapidly firing neurons)

Question 46

What is the one depolarizing neuromuscular blocking drug?

Answer 46

succinylcholine - strong ACh receptor agonist - produces sustained depolarization and prevents muscle contraction

Question 47

What are the non-depolarizing neuromuscular blocking drugs?

Answer 47

``` tobucurarine altracurium mivacurium pancuronium vecuronium ```

Question 48

What are the inhaled anesthetics? Side effects?

Answer 48

``` halothane - hepatotoxicity enflurane methoxyflurane - nephrotoxicity isoflurane N20 ```

Question 49

What is used to reverse toxic effects of benzos?

Answer 49

flumazenil